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1.
Journal of Clinical Hepatology ; (12): 1999-2004, 2022.
Article in Chinese | WPRIM | ID: wpr-942650

ABSTRACT

In March 2022, EASL released a new version of the clinical practice guidelines on haemochromatosis. Haemochromatosis is characterized by elevated transferrin saturation (TSAT) and progressive iron overload mainly involving the liver, and early diagnosis and venesection can prevent liver cirrhosis, hepatocellular carcinoma, diabetes, arthritis, and other complications. For patients with p.Cys282Tyr homozygous mutation of the hemochromatosis gene HFE , haemochromatosis can be diagnosed if serum iron parameters show TSAT > 45% and ferritin > 200 μg/L in female patients, or TSAT > 50% and ferritin > 300 μg/L in male patients and postmenopausal female patients. If a patient has elevated TSAT and ferritin and belongs to other HFE genotypes, magnetic resonance or liver biopsy is needed to confirm iron overload in the liver. Liver fibrosis stage and damage to other organs should be carefully assessed at the time of diagnosis, which will help to determine management strategies. Hepatocellular carcinoma should be screened for patients with progressive liver fibrosis. The goal of venesection is to achieve ferritin < 50 μg/L during the induction stage and ferritin < 100 μg/L during the maintenance stage.

2.
Article in Chinese | WPRIM | ID: wpr-940841

ABSTRACT

Objetive: To investigate the mechanism of antidepressant effect of verbascoside based on high-throughput sequencing technology (RNA-Seq),and to explore the possible targets and signaling pathways. MethodsForty C57BL/6 mice were randomly divided into control group,model group,fluoxetine group and verbascoside group,10 mice in each group. Except for the control group,all the other three groups were constructed with chronic unpredictable mild stimulation (CUMS) combined with solitary feeding for four weeks. Control group,fluoxetine group and verbascoside group were administered by gavage once daily for three weeks during the second week of modeling. The mice were assessed by sugar-water preference test,forced swimming test,open field test,elevated cross maze test,and water maze test. Enzyme linked immunosorbent assay(ELISA) was performed to detect the levels of major neurotransmitters and inflammatory factors in mice serum,and mRNA high-throughput sequencing was performed in the nucleus accumben and colon to screen differentially expressed genes and perform pathway enrichment analysis. Real-time polymerase chain reaction(Real-time PCR) was used to detect the mRNA expression of Gad,Slc32a1(VGAT) and brain-derived neurotrophic factor (BDNF) in nucleus accumbens. ResultCompared with the control group,the anxiety and depression-like behaviors in the model group increased,while the learning and memory ability decreased significantly. The content of neurotransmitter in serum decreased significantly. The content of pro-inflammatory factors increased significantly. The mRNA expression of Gad and Slc32a1(VGAT) in nucleus accumbens decreased significantly,while that of BDNF increased significantly. Compared with the model group,the anxiety and depression-like behavior of mice in verbascoside group was significantly relieved. The neurotransmitter content increased significantly,and the pro-inflammatory factors decreased significantly. The mRNA expression of Gad and Slc32a1(VGAT) in nucleus accumbens increased significantly,while that of BDNF decreased significantly.A total of 48 differentially expressed genes in nucleus accumbens and 43 differentially expressed genes in colon were screened by high-throughput sequencing. Differential genes in nucleus accumbens mainly focus on neuroactive ligand-receptor interaction, γ-aminobutyric acid(GABA)ergic synapse,synaptic vesicle cycle and other pathways. Colonic differential genes are mainly concentrated in GABAergic synapses,synaptic vesicle circulation,cyclic adenosine monophosphate(cAMP) signal pathway and other signal pathways. Compared with the control group,the mRNA expression of Gad and Slc32a1(VGAT) in nucleus accumbens of model group decreased significantly,while the mRNA expression of BDNF increased significantly. ConclusionVerbascoside has significant antidepressant effects. Its antidepressant effect may be related to the increase of monoamine neurotransmitters,the decrease of pro-inflammatory factors and the restoration of neurotransmitter homeostasis by increasing GABA,and it mainly acts through the signaling pathways such as neuroactive ligand-receptor interaction,GABAergic synapses,synaptic vesicle cycle and cAMP signaling pathway.

3.
Article in Chinese | WPRIM | ID: wpr-940690

ABSTRACT

ObjectiveTo establish a traditional Chinese medicine (TCM) syndrome model with yin deficiency and internal heat, discuss the rationality of model evaluation, and analyze differentially expressed genes in multiple dimensions to explore the molecular mechanism-signaling pathways as well as key targets of Baihe Dihuangtang (BHDH) in treating depression with Yin deficiency and internal heat. MethodForty male SD rats were randomly divided into a blank control group,a model group,a fluoxetine group (positive drug),a BHDH group, and a Zhibai Dihuangtang group (positive drug for Yin deficiency and internal heat). The depression model with Yin deficiency and internal heat was induced by chronic unpredictable mild stress (CUMS)combined with Chinese herbal drugs with warm and heat nature. The model established was comprehensively evaluated by the detection of the basic condition, behavioral performance, and biochemical indicators of rats in each group. The differentially expressed genes were screened out by mRNA sequencing and underwent Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analyses. The protein-protein interaction (PPI) network was plotted and key genes were analyzed to explore the underlying mechanism of BHDH in treating depression with Yin deficiency and internal heat. ResultThe comparison of basic conditions, behavioral assays, energy metabolism, endocrine hormones, cytokines, and neurotransmitters showed that the model was properly induced. BHDH could significantly improve depression with Yin deficiency and internal heat by regulating the pathways related to the nervous system, endocrine system, and inflammatory and immune system. The key genes of the PPI network were Fos, Epha8, Npy2r, Htr2c, and Nr4a1. ConclusionUnder the guidance of TCM theories of treatment based on syndrome differentiation and etiology and pathogenesis,this study established a depression model with yin deficiency and internal heat in animals and evaluation system in accordance with the symptoms and signs of emotional diseases, and further confirmed the scientificity of the modeling method and the underlying mechanism of BHDH in interfering with depression with Yin deficiency and internal heat based on the results of mRNA sequencing.

4.
Article in Chinese | WPRIM | ID: wpr-940370

ABSTRACT

In the clinical practice of rheumatic immune diseases in traditional Chinese medicine (TCM),it`s still unclear about the dominant diseases and breakthrough points. It`s urgent missions to formulate TCM diagnosis and treatment guidelines widely recognized and integrated by traditional Chinese medicine and Western medicine. In order to clarify the dominant diseases and breakthrough points in rheumatism,China association of Chinese medicine initiated a research group covering experts in the field of rheumatism of traditional Chinese medicine and Western medicine. Based on questionnaire survey and on-site discussion,experts had reached the following consensus. Evidence-based medicine research using modern medical methods and scientific methods should be carried out to provide objective clinical evidences. "Four mutuality" were put forward as the basis for the work of integrated traditional Chinese and Western medicine,that is the mutual communication using the exchangeable context,the mutual explanation using common theories,the mutual certification using common standards,and the mutual integration using common means. Key works should focus on solving refractory rheumatism in the future. In terms of dominant diseases and breakthrough points,this paper introduces 21 breakthrough points in 6 dominant diseases,including rheumatoid arthritis,ankylosing spondylitis,Sjogren's syndrome,hyperuricemia and gout,systemic lupus erythematosus and fibromyalgia syndrome. Advice on this discussion can provide valuable references for developing the treatment scheme of rheumatism with TCM and integrated Chinese and Western medicine and clinical practice and scientific research.

5.
International Eye Science ; (12): 1523-1527, 2022.
Article in Chinese | WPRIM | ID: wpr-940015

ABSTRACT

AIM:To evaluate the application effect of iris hooks combined with suture fixation of capsular tension ring(CTR)in the treatment of phacoemulsification with secondary glaucoma associated with lens subluxation.METHODS: Retrospective case series. A total of 18 eyes of patients with serious secondary glaucoma associated with lens subluxation were enrolled in Aier Eye Hospital(Changchun)from October 2017 to May 2020 as the observation group. All the patients had iris hooks inserted to support the capsule during the phacoemulsification combined with intraocular lens(IOL)implantation. Iris hooks were inserted through the incisions and placed in the capsulorhexis to support the capsule, then CTR was implanted and sutured onto the sclera of the dislocation side. A total of 11 eyes of patients had intracapsular cataract extraction combined with IOL suspension were enrolled in Aier Eye Hospital(Changchun)from October 2015 to October 2017 as the control group. The postoperative complications were recorded. The postoperative examinations included visual acuity, intraocular pressure(IOP)and positions of the capsule and IOL.RESULTS: The postoperative follow-up at least 12(12-40)mo, both the IOP of observation group and control group returned to normal, with statistically significant difference compared with pre-operation(t=9.994, 8.790, all P&#x003C;0.001). At 12mo after operation, the best corrected visual acuity of the two groups were significantly improved compared with surgery before(Z=-3.900, P&#x003C;0.001; Z=-3.002, P=0.003). The IOL in the observation group of the 18 eyes were in the expected position without complications such as an obvious tilt or displacement. In the control group with 11 eyes, the position of IOL in 8 eyes were centered, 3 eyes were slightly biased, and 2 eyes with cystoids macular edema.CONCLUSION: The application of suture fixation capsular tension ring and iris hooks for secondary glaucoma associated with lens subluxation in patients can be used as an effective auxiliary method, it could effectively control the IOP and maintain long-term stability of the capsule.

6.
Chinese Journal of Stomatology ; (12): 540-546, 2022.
Article in Chinese | WPRIM | ID: wpr-935899

ABSTRACT

With the advent of the era of big data, artificial intelligence based on machine learning, especially artificial neural network has rapidly developed and applicated in the field of stomatology, owning huge potential in segmentation and labelling of three-dimensional intraoral anatomical features. Automatic segmentation, labelling and diagnosis can assist dentists and technicians to complete heavy and repeat work, change stomatology from subjective perception to objective science, and help to make diagnosis and treatment plan efficiently and accurately. This review briefly summarized related knowledge and development of machine learning and artificial neural network, its application status and existing problems in the field of segmentation and labelling of three-dimensional intraoral anatomical features, and provided an outlook of its future development.


Subject(s)
Artificial Intelligence , Machine Learning , Neural Networks, Computer
7.
Chinese Journal of Stomatology ; (12): 358-365, 2022.
Article in Chinese | WPRIM | ID: wpr-935875

ABSTRACT

Objective: To explore the establishment of an efficient and automatic method to determine anatomical landmarks in three-dimensional (3D) facial data, and to evaluate the effectiveness of this method in determining landmarks. Methods: A total of 30 male patients with tooth defect or dentition defect (with good facial symmetry) who visited the Department of Prosthodontics, Peking University School and Hospital of Stomatology from June to August 2021 were selected, and these participants' age was between 18-45 years. 3D facial data of patients was collected and the size normalization and overlap alignment were performed based on the Procrustes analysis algorithm. A 3D face average model was built in Geomagic Studio 2013 software, and a 3D face template was built through parametric processing. MeshLab 2020 software was used to determine the serial number information of 32 facial anatomical landmarks (10 midline landmarks and 22 bilateral landmarks). Five male patients with no mandibular deviation and 5 with mild mandibular deviation were selected from the Department of Orthodontics or Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from June to August 2021. 3D facial data of patients was collected as test data. Based on the 3D face template and the serial number information of the facial anatomical landmarks, the coordinates of 32 facial anatomical landmarks on the test data were automatically determined with the help of the MeshMonk non-rigid registration algorithm program, as the data for the template method to determine the landmarks. The positions of 32 facial anatomical landmarks on the test data were manually determined by the same attending physician, and the coordinates of the landmarks were recorded as the data for determining landmarks by the expert method. Calculated the distance value of the coordinates of facial anatomical landmarks between the template method and the expert method, as the landmark localization error, and evaluated the effect of the template method in determining the landmarks. Results: For 5 patients with no mandibular deviation, the landmark localization error of all facial anatomical landmarks by template method was (1.65±1.19) mm, the landmark localization error of the midline facial anatomical landmarks was (1.19±0.45) mm, the landmark localization error of bilateral facial anatomical landmarks was (1.85±1.33) mm. For 5 patients with mild mandibular deviation, the landmark localization error of all facial anatomical landmarks by template method was (2.55±2.22) mm, the landmark localization error of the midline facial anatomical landmarks was (1.85±1.13) mm, the landmark localization error of bilateral facial anatomical landmarks was (2.87±2.45) mm. Conclusions: The automatic determination method of facial anatomical landmarks proposed in this study has certain feasibility, and the determination effect of midline facial anatomical landmarks is better than that of bilateral facial anatomical landmarks. The effect of determining facial anatomical landmarks in patients without mandibular deviation is better than that in patients with mild mandibular deviation.


Subject(s)
Adolescent , Adult , Algorithms , Anatomic Landmarks , Cephalometry/methods , Face/anatomy & histology , Female , Humans , Imaging, Three-Dimensional/methods , Male , Malocclusion , Middle Aged , Orthodontics , Software , Young Adult
8.
Chinese Journal of Stomatology ; (12): 162-167, 2022.
Article in Chinese | WPRIM | ID: wpr-935843

ABSTRACT

Objective: To evaluate the effect of adding a geometric feature on the accuracy of digital impressions obtained by intraoral scanners for implant restoration of edentulous jaw quantitatively. Methods: A dentiform model of the maxilla of completely edentulous arch with 6 implant analogs+scan bodies (No. 1-6) was selected as the reference model. Without geometric feature, the dentiform model was scanned by dental model scanner and repeated for 5 times as true value group. Before and after adding the geometric feature, the same operator used intraoral scanner A (Trios 3) and B (Aoralscan 2) to scan the dentiform model with the same scanning path. Each type of intraoral scanner scanned 10 times and ".stl " datas were obtained. The results were imported into reverse engineering software (Geomagic Studio 2015). The linear distances of center point of upper plane between sacn body 1 to 6 was calculated, denoted as D12, D13, D14, D15 and D16. Trueness was the absolute value subtracted from the measured value of the intraoral scanner groups and true value; precision was the absolute value of pairwise subtraction of the measured values in the intraoral scanner groups.The smaller the value, the better the accuracy or precision.With or without the feature, all scan data were statistically analyzed, and the effect of adding geometric feature on the trueness and precision of the two intraoral scanners were evaluated. Results: As for intraoral scanner A, with the feature in place, significant differences were found in D14, D15, D16 for tureness(t=2.66, 2.75, 2.95, P<0.05); the trueness for D16 decreased from (101.9±47.1) μm to (49.6±30.3) μm. On the other hand, with features on the edentulous area, the precision was significantly increased in D15 and D16 (U=378.00, 672.00, P<0.05); the precision for D15 decreased from 40.8 (45.1) μm to 13.1 (17.0) μm. As for intraoral scanner B, the trueness of D12, D13 and D14 after adding geometric features was significantly better than before (t=3.02, 2.66, U=22.00, P<0.05). With feature on the edentulous area, the trueness for D13 decreased from (116.6±41.2) μm to (70.8±35.5) μm. There was no statistical significance in the trueness of D15 and D16 with or without geometric feature (P>0.05), however, the precision of D15 and D16 after adding geometric feature was significantly better than before (U=702.00, 489.00,P<0.05). The precision of D16 decreased from 112.5 (124.7) μm to 35.9 (85.8) μm. Conclusions: The use of geometric feature in edentulous space improves the trueness and precision of the different principle intraoral scanners tested.


Subject(s)
Computer-Aided Design , Dental Implants , Dental Impression Technique , Imaging, Three-Dimensional , Models, Dental
9.
Chinese Journal of Epidemiology ; (12): 523-527, 2022.
Article in Chinese | WPRIM | ID: wpr-935421

ABSTRACT

Objective: To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods: From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results: A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ2=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ2=4.634, P=0.031). Conclusions: The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.


Subject(s)
China/epidemiology , Cities , Drug Resistance , Drug Resistance, Viral/genetics , Female , Genotype , HIV Infections/epidemiology , HIV Seropositivity/drug therapy , HIV-1/genetics , Homosexuality, Male , Humans , Male , Phylogeny , Reverse Transcriptase Inhibitors/therapeutic use , Sexual and Gender Minorities
10.
Article in Chinese | WPRIM | ID: wpr-933628

ABSTRACT

Objective:To investigate the effect of albumin to fibrinogen ratio on the prognosis of patients undergoing radical resection for colorectal cancer.Methods:Clinical and pathological data of 216 patients who underwent laparoscopic radical resection of colorectal cancer at the General Surgery Department of Taizhou People's Hospital from Aug 2015 to Jul 2017 were retrospectively analyzed. Albumin and fibrinogen results within 7 days before surgery was collected. The optimal cut-off point of AFR was determined by Youden index of ROC curve. Kaplan-Meier analysis, univariate and multivariate COX regression models were used to analyze the prognostic factors of OS and DFS.Results:The best postoperative OS threshold of AFR for patients undergoing laparoscopic radical resection of colorectal cancer was 9.43. Univariate analysis and multivariate COX regression analysis showed that age ≤65 years, TNM stage Ⅰ-Ⅱ, and AFR≥9.43 had better OS and DFS (all P<0.05). Conclusions:Preoperative AFR level had a good predictive value on postoperative survival of patients undergoing laparoscopic radical resection of colorectal cancer, and AFR<9.43 was an independent risk factor for postoperative OS and DFS.

11.
Chinese Journal of Orthopaedics ; (12): 618-625, 2022.
Article in Chinese | WPRIM | ID: wpr-932873

ABSTRACT

Objective:To explore the clinical features and treatment strategies of the transsyndesmotic ankle fracture dislocation.Methods:Data of 26 patients of transsyndesmotic ankle fracture dislocation who were treated in our hospital from December 2013 to November 2020 were retrospectively analyzed. There were 16 men and 10 women with an average age of 49.54±12.81 years (range, 26-68 years). Open injuries in 17 cases, of which the Gustilo-Anderson II type in 6 cases, IIIA type in 11 cases, closed injuries in 9 cases. According to the AO/OTA fracture classification, 44B type in 4 cases, 44C type in 22 cases. According to the Lauge-Hansen classification, there were 16 cases of pronation-abduction, 10 cases of pronation-external rotation, including 4 cases of Maisonneuve fractures, and of the 4 cases of Maisonneuve fractures, there were 3 cases of double Maisonneuve fracture. The talar dislocation was anterior, neutral, and posterior within the distal tibiofibular joint in 10 cases, 7 cases, and 9 cases. Fibular fractures in 26 cases, medial malleolar fractures in 24 cases, deltoid ligament rupture in 2 cases, posterior malleolar fractures in 13 cases, and anterior malleolar fractures in 8 cases. All closed injuries were closed reduction and plaster fixation and all open injuries were emergently debridement and reduced under the tibial plafond in the emergency department. Surgical treatment was taken until the soft tissue conditions to be allowed. The reduction quality was assessed by postoperative radiography according to the criteria proposed by Burwell-Charnley. The function of the ankle joint was assessed by the ankle-hindfoot rating system of the American Orthopaedic Foot and Ankle Society (AOFAS), and the posttraumatic arthritis and objectively quantified was assessed using the Kellgren-Lawrence grading scale.Results:There were 4 cases were unreduced due to the tibial posterior tendon to flip through the ankle joint and dislocate anterior to the tibia through the interosseous membrane. Stabilization of fibular fractures were achieved with plate in 25 cases. There were 24 cases of medial malleolar fractures, and the fixation were achieved with cannulated screws in 23 cases and with K-wire fixation in 1 case. There were 12 cases of posterior malleolar fractures treated with open reduction and internal fixation including cannulated screws in 9 cases and antiglide plates in 3 cases. There were 7 cases of anterior malleolar fractures treated with open reduction and internal fixation including suture anchors in 1 case and cannulated screws in 6 cases. Stabilization of syndesmosis was achieved with syndesmotic screws in 14 cases and with TightRope in 2 cases. All patients were followed up for 20.23±9.70 months (range, 12-60 months). According to the Burwell-Charnley criteria of reduction quality, anatomic reduction was obtained in 22 cases, and satisfactory reduction was gained in 4 cases. All fractures healed in 16.31±3.64 weeks (range, 10-24 weeks). Functional examination of the ankle joint (angle measurement method): dorsiflexion average angle 10.38°±6.66°, plantarflexion average angle 34.04°±7.20°. At latest follow up, the AOFAS score was 83.30±13.94 (range, 24-100). Ten (38%) of 26 patients had radiographic evidence of posttraumatic ankle arthritis. According to the Kellgren-Lawrence grading scale criteria, there were grade I in 5 cases, II in 2 cases, III in 2 cases, and IV in 1 case. 2 cases of wound dishence were recovered through changing dressing and 2 cases of skin necrosis were recovered by skin graft and flap transposition respectively. There were no significant complications such as infection, nonunion, or implant failure.Conclusion:The transsyndesmotic ankle fracture dislocation, represents an exceptional pattern of high-energy fractures with significant syndesmotic disruption, and potential soft tissue compromise. Careful attention to radiographic findings can identify unique fracture characteristics relative to operative decision-making. Tibialis posterior tendon dislocation, a rare complication in the transsyndesmotic ankle fracture dislocation injuries, can impede anatomical reduction of the ankle mortise. The open reduction and internal fixation may be an optimal approach to treat transsyndesmotic ankle fracture dislocation injuries. However, the rate of posttraumatic arthritis is relatively high.

12.
Article in Chinese | WPRIM | ID: wpr-932697

ABSTRACT

It is necessary to place bolus on skin to increase the surface dose when using high-energy rays to treat superficial lesions because of its build-up effect. It is well known that the set-up reproducibility of hand-made bolus is poor, and the main concern of commercialized bolus is the inadvertent air gap between the bolus and irregular skin. Owing to the advantage of making individualized and complex-shaped bolus, 3D-printing technology is playing an important role in making the bolus. The aim of this review is to summarize the current research status of hand-made, commercialized and 3D-printed bolus materials and future development trend of the bolus, providing reference for clinical application.

13.
Article in Chinese | WPRIM | ID: wpr-932559

ABSTRACT

Objective:To evaluate the effects of simultaneous integrated boost intensity-modulated radical radiotherapy (SIB-IMRT) on the long-term prognosis of patients with cervical and upper thoracic esophageal cancer.Methods:From January 2011 to December 2014, a retrospective analysis was performed in 172 patients with cervical and upper thoracic esophageal cancer who were eligible for IMRT. First, the prognosis of all the patients was evaluated using single factor and multivariate analyses. According to the different irradiation method of the patients, the patients were divided into two groups, one of which received conventional IMRT (C-IMRT) and the other of which received SIB-IMRT. Propensity score matching (PSM) analysis was applied to match the two groups of patients and to determine the treatment efficacy of patients after PSM, prognostic factors, failure modes, and side effects. SPSS19.0 statistical software was used to conduct statistical analysis.Results:The median overall survival (OS) and progression-free survival (PFS) times of all the patients were 30 months and 20 months, respectively. The fact whether the surrounding tissues and organs of esophageal lesions were invaded, clinical node staging (cN staging), chemotherapy, and GTV-maximum transverse diameter were observed to be independent influencing factors of OS and PFS in all the patients ( P<0.001, P=0.013, 0.005, 0.002; P<0.001, P=0.017, 0.034, 0.002). In addition, the independent influencing factors of PFS showed short-term efficacy ( P=0.036). After PSM, there were 54 patients in each of the two groups. The result of multivariate analysis showed that the fact whether the surrounding tissues and organs of esophageal lesions were invaded, cN staging, cTNM staging, prescribed dose, GTV-maximum transverse diameter, and irradiation method were independent factors affecting the OS ( P<0.001, P=0.008, 0.014, 0.021, 0.010, 0.008). Similarly, the fact whether the surrounding tissues and organs of esophageal lesions were invaded, cN staging, and GTV-maximum transverse diameter were observed to be independent factors that affect the PFS of patients ( P<0.001, P=0.044, 0.013). The difference in the total failure rate (70.4% vs. 50.0%) and the local regional recurrence rate (61.1% vs. 31.5%) between the C-IMRT and SIB-IMRT groups after treatment was significant ( χ2=4.68, 9.53, P=0.031, 0.002). The incidence of radiation pneumonitis of grade ≥ 1 in the C-IMRT group was significantly higher than that of the SIB-IMRT group ( χ2=6.16, P=0.046), whereas the leukocyte suppression of grade ≥ 2 in the C-IMRT group was significantly lower than that in the SIB-IMRT group ( χ2=12.77, P=0.005). Conclusions:As shown by the result of this study, compared with C-IMRT, SIB-IMRT can improve the OS of patients with cervical and upper thoracic esophageal cancer to a certain extent. Whether SIB-IMRT can improve the PFS of patients requires further research.

14.
Article in Chinese | WPRIM | ID: wpr-932402

ABSTRACT

Objective:To evaluate the cardiac function and systolic dyssynchrony of fetuses exposed to maternal autoimmune antibodies (anti-SSA/Ro60, anti-SSA/Ro52 and anti-SSB/La) by using two-dimensional speckle tracking imaging (2D-STI).Methods:A total of 52 pregnant women with singleton pregnancy in the Affiliated Hospital of Inner Mongolia Medical University from July 2018 to November 2020 were selected. Eighteen fetuses of mothers with autoimmune antibodies were enrolled as autoimmune disease (AD) group and 34 fetuses of healthy mothers without antibodies were included as control group. Maternal baseline characteristics, fetoplacental Doppler parameters, and conventional echocardiographic data of two groups were prospectively collected. The systolic global and regional longitudinal strain of left and right ventricles (LV and RV) and the time to peak strain of regional myocardium were measured using 2D-STI. The differences in time to peak strain between the LV free wall and RV free wall (two-chamber dyssynchrony, 2C-DYS) and between the septum and LV free wall (one-chamber dyssynchrony, 1C-DYS) were also calculated.Results:There were no significant differences between the two groups in conventional systolic and diastolic functional parameters for the LV and RV(all P>0.05). The myocardial deformation parameters and 2C-DYS obtained by 2D-STI showed no statistical differences between two groups(all P>0.05). However, 1C-DYS was significantly more prolonged in the AD group than control group[28.50(13.50, 39.25)ms vs 19.50(8.00, 29.25)ms, P=0.042]. Conclusions:LV systolic mechanical dyssynchrony in fetuses of mothers with autoimmune antibodies suggests in-utero subclinical damage of the cardiac conduction system.

15.
Chinese Journal of Trauma ; (12): 23-31, 2022.
Article in Chinese | WPRIM | ID: wpr-932206

ABSTRACT

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

16.
Article in Chinese | WPRIM | ID: wpr-931581

ABSTRACT

Objective:To investigate the feasibility and efficacy of retroperitoneal laparoscopy combined with lower abdominal incisions in the surgical treatment of upper urinary tract urothelial cell carcinoma.Methods:The clinical data of 52 patients with renal pelvic and ureteral cancer, who received radical nephrectomy using the retroperitoneal laparoscopy combined with a lower abdomen incision approach in Hubei Provincial General Hospital of Armed Police Force from April 2005 to December 2016, were retrospectively analyzed. All 52 patients had unilateral renal pelvic and ureteral cancer but with no lymph nodes or distant metastasis. During general anesthesia in a healthy side-lying position, patients underwent retroperitoneal laparoscopic radical nephrectomy. The affected ureter was clamped but not disconnected. Renal blood vessels were clamped with Hem-o-lock clips. Renal arteries and veins were cut off. Then the kidney was completely isolated. Three laparoscopic incisions were sutured. After taking the patients to be in the supine position, a 5-6 cm-long incision was made in the lower abdomen on the affected side. The lower ureter was dissociated from the bladder. A 1.5 cm-long bladder wall was dissected in the sleeve manner. The affected kidney and ureter were completely removed from the lower abdomen through the made small incision. A rubber drainage tube was inserted in another incision made at the lower end of the prior incision.Results:Operations were successful in all 52 cases. No cases were converted to open surgery, had blood transfused, or needed secondary surgery. There were no complications such as urinary leakage, incision infection, or massive bleeding. Postoperative pathology reported 41 cases of renal urothelial carcinoma and 11 cases of ureteral urothelial carcinoma. Forty-eight patients provided follow-up data, and four did not because of being lost. One patient died of a cardiovascular accident 13 months after surgery. Cystoscopy revealed that 47 cases had no bladder tumor, local or distant metastasis.Conclusion:The retroperitoneal laparoscopy combined with lower abdominal incisions approach is suitable for radical resection of renal pelvic or ureteral cancer owing to ease in operation, few requirements for surgical instruments, minimal invasion, and rapid recovery.

17.
Article in Chinese | WPRIM | ID: wpr-930230

ABSTRACT

Objective:To investigate the effect of extracellular vesicles derived from lung tissue on intrapulmonary inflammation and the formation of neutrophil extracellular traps (NETs) in sepsis rats.Methods:Sepsis rat model was established by cecal ligation and puncture (CLP). Collagenase D and DNase I were used to dissociate the lung tissue, the impurities were removed by centrifugation, and finally, the extracellular vesicles (Ti-EVs) derived from lung tissue were separated and extracted by differential ultracentrifugation. Eighteen male SD rats were randomly divided into the sham group, sepsis group and Ti-EVs group: in the Ti-sEV group, a sepsis model was established by CLP, and Ti-EVs suspension was instilled through the airway; rats in the CLP group received CLP, and an equal volume of PBS was instilled through the airway; and rats in the sham group was treated with sham operation. The pathological changes of lung tissue were detected by hematoxylin-eosin (HE) staining after 24 h. The content of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the bronchoalveolar lavage fluid (BALF) was measured by enzyme-linked immunosorbent assay (ELISA). Immunofluorescence was used to detect the NETs content in lung tissue.Results:The isolated extracellular vesicles derived from rat lung tissue were observed by transmission electron microscopy as double-layer circular cystic vesicles with particle diameter mainly distributed at 150 nm. Western blot showed positive expression of EVs markers CD9, CD63, and Tsg101. HE staining of lung tissue showed alveolar integrity damage and a large number of inflammatory cells infiltrated in the lung of sepsis rats. Compared with the CLP group, the degree of lung tissue damage was more serious in the Ti-EVs group and the levels of IL-1β, TNF-α and IL-6 in the BALF of rats were significantly increased ( P<0.01). The formation of NETs in the lungs of the rats in the sepsis group and the Ti-EVs group was observed under the laser confocal microscope. Compared with the sepsis group, the fluorescence intensity of NETs in the lung tissues of the Ti-EVs group increased significantly. Conclusions:After enzymatic digestion, differential ultracentrifugation and other treatments, the extracellular vesicles derived from rat lung tissue with high purity can be successfully isolated and extracted. In the process of septic lung injury, extracellular vesicles in lung tissue can aggravate the inflammatory response in the lung and promote the formation of NETs.

18.
Article in Chinese | WPRIM | ID: wpr-929596

ABSTRACT

ObjectiveTo screen the risk factors of osteoporosis in perimenopausal women, and to provide direction for timely prevention and treatment. MethodsUsing multilevel stratified random sampling method, the perimenopausal women were investigated by questionnaire survey, and the determination of bone mineral density (BMD) and the levels of several important hormones. ResultsA total of 720 valid questionnaires were received. Among 720 perimenopausal women, 173 had osteoporosis and 547 had no osteoporosis. Univariate analysis of the influencing factors of osteoporosis showed that the levels of parathyroid hormone (PTH), Estradiol (E2), body mass index (BMI), age, time of last period and age of menopause were significantly different among perimenopausal women in the prevalence of osteoporosis(χ2=4.23, 4.86, 16.06, 21.04, 10.52, 13.02; P<0.05).Logistic regression analysis showed that the increase of PTH (OR=2.70, P<0.05)and menopause (OR=1.76, P<0.05) were the risk factors of osteoporosis . Higher BMI(OR=0.65, P<0.05), higher personal monthly income(OR=0.72, P<0.05), longer sunshine time(OR=0.69, P<0.05), were the protective factors against osteoporosis. ConclusionThe increase of PTH levels and menopause are the risk factors for osteoporosis in women. Perimenopausal women should be monitored for bone mineral density and appropriate intervention. Necessary treatment measures should be taken for the patients with osteopenia and osteoporosis.

19.
Article in English | WPRIM | ID: wpr-928831

ABSTRACT

BACKGROUND@#Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution.@*METHODS@#Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM.@*RESULTS@#A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02-1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30-1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates.@*CONCLUSIONS@#This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD.


Subject(s)
Beijing/epidemiology , China/epidemiology , Dysentery, Bacillary/epidemiology , Humans , Humidity , Temperature
20.
Article in Chinese | WPRIM | ID: wpr-928618

ABSTRACT

OBJECTIVES@#To study the etiology and clinical features of children with ascites, so as to provide a basis for the diagnosis and treatment of ascites in children.@*METHODS@#The medical data of the children with ascites, who were hospitalized from January 1, 2010 to December 31, 2019, were retrospectively reviewed.@*RESULTS@#Among the 165 children with ascites, the male/female ratio was 1.53:1, and the mean age of onset was (6±4) years. The causes of ascites included surgical acute abdomen (39 children, 23.6%), infectious diseases (39 children, 23.6%), neoplastic diseases (27 children, 16.4%), hepatogenic diseases (18 children, 10.9%), pancreatitis (10 children, 6.1%), cardiogenic diseases (8 children, 4.8%), rheumatic immune diseases (6 children, 3.6%), and nephrogenic diseases (5 children, 3.0%). According to the age of onset, there were 33 infants, 24 young children, 30 preschool children, 41 school-aged children, and 37 adolescents. Surgical acute abdomen and hepatogenic diseases were the main causes of ascites in infants (P<0.05). Neoplastic disease was the leading cause in young children (P<0.05). Infectious diseases were the most common cause in adolescents (P<0.05).@*CONCLUSIONS@#Surgical acute abdomen, infectious diseases, neoplastic diseases, and hepatogenic diseases are the common causes of ascites in children, and there are some differences in the leading cause of ascites between different age groups.


Subject(s)
Abdomen, Acute/complications , Adolescent , Ascites/etiology , Child , Child, Preschool , Communicable Diseases , Female , Humans , Infant , Male , Neoplasms/complications , Pancreatitis/complications , Retrospective Studies
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